Witte Wolfgang, Kresken Michael, Braulke Christine, Cuny Christa
Robert Koch Institute, Wernigerode Branch, Wernigerode, and.
Clin Microbiol Infect. 1997 Aug;3(4):414-422. doi: 10.1111/j.1469-0691.1997.tb00277.x.
to present data on prevalence and interregional spread of methicillin-resistant Staphylococcus aureus (MRSA) in Germany. METHODS: A nationwide collection of MRSA isolates from nosocomial infections in 143 hospitals was established from isolates (n=4368) sent to a microbiological reference center during 1993--95. As chosen by distinguishable resistance phenotypes at each time of occurrence during the study period, 1830 isolates were subjected to molecular typing by means of Smal macrorestriction patterns, PCR for RNA gene spacer patterns, and PCR for patterns of DNA stretches flanked by the ERIC-2 sequence and flanked by Tn916 and ribosomal binding site. In addition, data from a multicenter study on the incidence of antibiotic resistance have been analyzed (32 centers, 637 S. aureus isolates). RESULTS: In 1995 the prevalence of MRSA among S. aureus isolates was 8.7% overall in central Europe (including Germany), in comparison to 1.7% in 1990. From 1993 until now, a continuous interregional dissemination of six epidemic strains, which were identified by molecular typing, was recorded. Besides these epidemic strains, 15 MRSA strains were identified which could not be allocated to the epidemic MRSA or to the known clonal groups of the species S. aureus. MRSA from three cases of sporadic nosocomial infections exhibited characteristics of the clonal group of S. aureus with the capacity for toxic shock syndrome formation. The pattern of one MRSA corresponded to those of the S. aureus group exhibiting phage pattern 94,96. CONCLUSIONS: The prevalence of MRSA has increased in central Europe (and Germany) during the last 5 years, to 8.7%. The main source of infection with MRSA is obviously interregional dissemination of epidemic strains. At the same time, the mecA gene has been acquired by strains previously sensitive to methicillin.
呈现德国耐甲氧西林金黄色葡萄球菌（MRSA）的流行情况及区域间传播的数据。方法：1993 - 1995年期间，从143家医院送至微生物参考中心的医院感染MRSA分离株（n = 4368）建立了全国性收集。在研究期间每次出现时，根据可区分的耐药表型选择1830株分离株，通过Smal宏观限制性图谱、RNA基因间隔区图谱PCR以及ERIC - 2序列两侧、Tn916和核糖体结合位点两侧DNA片段图谱PCR进行分子分型。此外，分析了一项关于抗生素耐药性发生率的多中心研究数据（32个中心，637株金黄色葡萄球菌分离株）。结果：1995年，在中欧（包括德国），金黄色葡萄球菌分离株中MRSA的总体流行率为8.7%，而1990年为1.7%。从1993年至今，记录到通过分子分型鉴定的6种流行菌株的持续区域间传播。除了这些流行菌株外，还鉴定出15株MRSA菌株，它们不能归入流行的MRSA或已知的金黄色葡萄球菌克隆群。3例散发性医院感染的MRSA表现出具有形成中毒性休克综合征能力的金黄色葡萄球菌克隆群特征。一株MRSA的图谱与噬菌体图谱94、96的金黄色葡萄球菌组图谱一致。结论：在过去5年中，中欧（和德国）MRSA的流行率已升至8.7%。MRSA感染的主要来源显然是流行菌株的区域间传播。与此同时，以前对甲氧西林敏感的菌株获得了mecA基因。
